Reimbursement changing for out-of-network surgery centers

Providence Health Plan is changing how it reimburses out-of-network ambulatory surgical centers. In recent time, we have seen a greater fluctuation in the rates charged at out-of-network surgery centers versus at in-network surgery centers. As a result, we will reimburse our out-of-network surgical centers at reasonable community rates beginning May 15. This change may result in your patients experiencing greater out-of-pocket costs.

We have communicated this change to our members and employer groups, as well as our reasons for changing the way we reimburse out-of-network surgical centers.

Part of our Mission at Providence Health Plan is to be a good steward of our resources, for our members and our providers. This change aligns with our core value of stewardship.

Thank you for your understanding as we implement this change. If you have any questions, please contact your provider relations representative.